Changes in Diagnostic Cardiac Catheterization and Revascularization Rates for Coronary Heart Disease in Alberta Regional Health Authorities between 2003 and 2005
and Province-Wide Trends 1995-2005.

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Background: The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) maintains a clinical registry of all patients undergoing diagnostic cardiac catheterizations and subsequent cardiovascular procedures in Alberta. Although Alberta appears “on average” to be doing well relative to other Canadian provinces, this study addresses the equitability of cardiac care delivery across Alberta health regions in 2003-2005.

Objectives:To examine the age- and sex-adjusted rates of diagnostic cardiac catheterization, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in Alberta health regions from 2003 to 2005. In addition, we examined province-wide trends in procedure rates from 1995 to 2005.

Methods: Data from the APPROACH registry were used to calculate age- and sex-adjusted procedure rates for persons aged 20 and older in each health region. 1996 StatsCan data were used for adjusting rates by age and sex. We used maps, tables and graphs to show the distribution of rates in the Alberta regional health authorities in 2003-2005. We used tables and figures to show province-wide trends in procedure rates and counts from 1995 to 2005.

Results and Conclusions: Provincial catheterization rates and PCI rates increased between 2003 and 2005. The overall age- and sex-adjusted catheterization rate was 480 per 100,000 in 2003, 515 per 100,000 in 2004 and 489 per 100,000 in 2005. The overall age- and sex-adjusted PCI rate for Alberta residents was 186 per 100,000 in 2003, 204 per 100,000 in 2004, and 189 per 100,000 in 2005. In contrast, the CABG rate declined over this period of time, and the provincial age- and sex-adjusted CABG rates for Alberta residents decreased from 84 per 100,000 in 2003 to 73 per 100,000 in 2004 to 72 per 100,000 in 2005. The ratio of PCI procedures performed for every CABG procedure increased from 2.21 in 2003 to 2.80 in 2004 and decreased to 2.63 in 2005. For both CABG and PCI procedures, rates tended to be lower in regions serviced by facilities in the Calgary Health Region than in regions serviced by Capital Health, and in 2004, the Calgary and Palliser Health Regions had the lowest combined CABG and PCI procedure rates in the province in 2005. Cardiac catheterization and PCI procedure rates increased from 1995 to 2005, but CABG rates showed little change. Increases in the number of catheterization and PCI procedures were more dramatic, while CABG counts have remained constant.